Lifetime prevalence of epilepsy in urban Tanzania – A door-to-door random cluster survey

Abstract

Objectives Epileptic seizures and epilepsy in urban settings of low-income and middle-income countries (LMIC) are largely under-researched, but their prevalence is necessary for good healthcare planning. This study aimed to determine the lifetime prevalence of epileptic seizures and epilepsy in urban Dar es Salaam. Methods Nearly 50,000 people in former Kinondoni district, Dar es Salaam, were screened for epileptic seizures using a set of nine questions. Answers to these nine questions were categorized into generalized, focal, and unspecified seizures. Screening positivity rates were adjusted for questionnaire inaccuracy using two scenarios to analyse true epilepsy prevalences. Results Overall, 1085 (2.23%) people fulfilled the criteria for ever having had at least one type of epileptic seizure. Two-hundred-ninety-six (0.60%) people screened positive for generalized seizures, 986 (2.02%) for focal seizures, and 32 (0.07%) for unspecified seizures. Women more commonly screened positive than men (2.61% versus 1.72%, p < 0.001), particularly for focal seizures (p < 0.001). Adjusting for different degrees of accuracy of the screening questionnaire yielded true lifetime prevalences for epilepsy of any type between 1.59% and 2.41%. We furthermore observed a considerable variation of screening positivity rates between wards in Kinondoni district ( p < 0.001). Conclusion The prevalence of epilepsy, based on a questionnaire survey in urban Tanzania, was higher than previously observed, probably due to the screening questionnaire, which contained questions specifically designed to identify focal seizures. Further studies on epileptic seizures/epilepsy are needed for urban settings in LMIC, preferably with an integrated follow-up of positive cases.

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

“…Lifetime prevalence of epileptic seizures was calculated to be 2.8% (2.9% accounting for loss to follow-up and between 3.0% and 5.3% further accounting for verification and misclassification bias) for epileptic seizures and 1.1% (0.8% accounting for loss-to-follow-up, and between 1.2% and 3.4% further accounting for verification and misclassification bias) for epilepsy, respectively. These results are comparable to other African studies reporting lifetime epileptic seizure prevalence estimates of about 3% [26,27]. These findings are also line with a recent meta-analysis for sub-Saharan Africa revealing a lifetime prevalence for epilepsy of 1.6% and a prevalence for active epilepsy of 0.9% [28].…”

“…Unfortunately, screen positives were not further evaluated in that study to confirm wether the person really had focal seizures. Additionnally, questions screening for focal and non-motor seizures often face the problem of being too unspecific [ 27 ]. Because of that and due to our NCC-specific study setting we focused on detection of recent generalized motor seizures (see major criteria) as generalized seizures and focal seizures with secondary generalization represent the most common seizure types experienced in people with NCC [ 44 ].…”

“…This is a phenomenon frequently observed in field PLOS NEGLECTED TROPICAL DISEASES epidemiological studies and is a result of the underlying definitions, as single epileptic seizures may occur due to various conditions (e.g. fever) or even spontaneously without underlying epilepsy (see also www.ilae.org) [27,37]. In our study, this discrepancy was mainly due to a high number of PWE suffering from seizures in childhood only, without actual hints for underlying persistent epilepsy, and consequently not particularly relevant for further evaluation in our NCC-specific setting.…”

EEG-Based Epileptic Seizure Detection via Machine/Deep Learning Approaches: A Systematic Review

“…Epileptic seizure is a well-known chronic neurological and noncommunicable disease, occurring in 4% to 16% of organ recipients and a ecting between 60-70 million people worldwide [1]. Epilepsy can be observed at any age, with a higher incidence in infants and the elderly.…”

“…Epilepsy can be observed at any age, with a higher incidence in infants and the elderly. Every year, around three million people are a ected by this disease [1][2][3][4]. An epileptic seizure is a sudden abnormality in the brain's electrical activities, manifesting as excessive discharges of neuronal networks in the cerebral cortex and affecting the whole body [2].…”